Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 57
Filtrar
1.
Lancet ; 403(10433): 1254-1266, 2024 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-38461840

RESUMO

BACKGROUND: Mental health difficulties are common in children and young people with chronic health conditions, but many of those in need do not access evidence-based psychological treatments. The study aim was to evaluate the clinical effectiveness of integrated mental health treatment for children and young people with epilepsy, a common chronic health condition known to be associated with a particularly high rate of co-occurring mental health difficulties. METHODS: We conducted a parallel group, multicentre, open-label, randomised controlled trial of participants aged 3-18 years, attending epilepsy clinics across England and Northern Ireland who met diagnostic criteria for a common mental health disorder. Participants were randomised (1:1; using an independent web-based system) to receive the Mental Health Intervention for Children with Epilepsy (MICE) in addition to usual care, or assessment-enhanced usual care alone (control). Children and young people in both groups received a full diagnostic mental health assessment. MICE was a modular psychological intervention designed to treat common mental health conditions in children and young people using evidence-based approaches such as cognitive behaviour therapy and behavioural parenting strategies. Usual care for mental health disorders varied by site but typically included referral to appropriate services. Participants, along with their caregivers, and clinicians were not masked to treatment allocation but statisticians were masked until the point of analysis. The primary outcome, analysed by modified intention-to-treat, was the parent-report Strengths and Difficulties Questionnaire (SDQ) at 6 months post-randomisation. The study is complete and registered with ISRCTN (57823197). FINDINGS: 1401 young people were potentially deemed eligible for study inclusion. Following the exclusion of 531 young people, 870 participants were assessed for eligibility and completed the SDQ, and 480 caregivers provided consent for study inclusion between May 20, 2019, and Jan 31, 2022. Between Aug 28, 2019, and Feb 21, 2022, 334 participants (mean ages 10·5 years [SD 3·6] in the MICE group vs 10·3 [4·0] in control group at baseline) were randomly assigned to an intervention using minimisation balanced by age, primary mental health disorder, diagnosis of intellectual disability, and autistic spectrum disorder at baseline. 168 (50%) of the participants were female and 166 (50%) were male. 166 participants were randomly assigned to the MICE group and 168 were randomly assigned to the control group. At 6 months, the mean SDQ difficulties for the 148 participants in the MICE group was 17·6 (SD 6·3) and 19·6 (6·1) for the 148 participants in the control group. The adjusted effect of MICE was -1·7 (95% CI -2·8 to -0·5; p=0·0040; Cohen's d, 0·3). 14 (8%) patients in the MICE group experienced at least one serious adverse event compared with 24 (14%) in the control group. 68% percent of serious adverse events (50 events) were admission due to seizures. INTERPRETATION: MICE was superior to assessment-enhanced usual care in improving symptoms of emotional and behavioural difficulties in young people with epilepsy and common mental health disorders. The trial therefore shows that mental health comorbidities can be effectively and safely treated by a variety of clinicians, utilising an integrated intervention across ages and in the context of intellectual disability and autism. The evidence from this trial suggests that such a model should be fully embedded in epilepsy services and serves as a model for other chronic health conditions in young people. FUNDING: UK National Institute for Health Research Programme Grants for Applied Research programme and Epilepsy Research UK Endeavour Project Grant.


Assuntos
Epilepsia , Deficiência Intelectual , Adolescente , Criança , Feminino , Humanos , Masculino , Análise Custo-Benefício , Inglaterra , Epilepsia/terapia , Saúde Mental , Intervenção Psicossocial , Resultado do Tratamento , Pré-Escolar
2.
Xenotransplantation ; 31(3): e12860, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38716636

RESUMO

BACKGROUND: Recent advances mean that formal clinical trials of solid organ xenotransplantation are increasingly likely to begin and patients requiring a kidney transplant could be the first participants. Healthcare workers and healthcare students constitute the current and future workforce that will influence public opinion of xenotransplantation. The attitudes of these populations are important to consider before recruitment for formal clinical trials begins. METHODS: This scoping review was reported according to the PRISMA extensions for scoping reviews checklist and the Joanna Briggs Institute methodology for scoping reviews. The Scopus, PubMed, and ScienceDirect databases were searched to identify articles that studied the attitudes of healthcare workers, healthcare students, or kidney patients toward xenotransplantation. RESULTS: The search generated 816 articles, of which 27 met the eligibility criteria. The studies were conducted in 14 different countries on five different continents. Participants from the 27 studies totaled 29,836-this was constituted of 6,223 (21%) healthcare workers, 21,067 (71%) healthcare students, and 2,546 (8%) kidney patients. All three groups had an overall positive attitude toward xenotransplantation. However, in studies where participants were asked to consider xenotransplantation when the risks and results were not equal to allotransplantation-the overall attitude switched from positive to negative. The results also found that Spanish-speaking populations expressed more favorable views toward xenotransplantation compared to English-speaking populations. CONCLUSION: The results of this review suggest that while attitudes of the three groups toward xenotransplantation are-on the face of it-positive, this positivity deteriorates when the risks and outcomes are framed in more clinically realistic terms. Only formal clinical trials can determine how the risks and outcomes of xenotransplantation compare to allotransplantation.


Assuntos
Pessoal de Saúde , Transplante de Rim , Transplante Heterólogo , Humanos , Atitude do Pessoal de Saúde , Animais
3.
J Ment Health ; 33(4): 500-506, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38588707

RESUMO

BACKGROUND: Early intervention for people diagnosed with bipolar disorder has been identified as a priority, but little is known about how existing early intervention services are experienced by this group or could be tailored to their needs. AIMS: This study examined the experience of early intervention in psychosis (EIP) services for people diagnosed with bipolar disorder, following first episode psychotic mania. METHOD: Semi-structured interviews were conducted with 11 adults in EIP services and analysed using Interpretative Phenomenological Analysis. RESULTS: One superordinate theme was formed, Rebuilding within EIP service, consisting of five subthemes: (i) Piecing together episode through talking to staff; (ii) Exploring other perspectives during CBT; (iii) Empowered through shared decision-making; (iv) Reconsidering future and purpose; (v) Service as safety-net. EIP provision was pivotal in helping participants understand their episode, adjust their perspective, build confidence and progress. CONCLUSIONS: Aspects of the service that were valued, including person-centred relationships with staff, shared decision-making and the development of motivation and opportunities, reflect key principles of mental health care for young people following first episode psychosis. Furthermore, findings point to elements that may be particularly relevant to early intervention following first episode psychotic mania including managing mood escalation and individualised approaches to goals.


Assuntos
Transtorno Bipolar , Transtornos Psicóticos , Humanos , Transtorno Bipolar/terapia , Transtorno Bipolar/psicologia , Adulto , Masculino , Feminino , Transtornos Psicóticos/terapia , Transtornos Psicóticos/psicologia , Transtornos Psicóticos/diagnóstico , Adulto Jovem , Intervenção Médica Precoce , Mania/psicologia , Serviços de Saúde Mental , Pesquisa Qualitativa
4.
Hum Reprod ; 35(4): 876-885, 2020 04 28.
Artigo em Inglês | MEDLINE | ID: mdl-32268357

RESUMO

STUDY QUESTION: What is it like for women to be involuntarily childless in midlife? SUMMARY ANSWER: Involuntarily childless women may be suffering from prolonged grief due to its ambiguous and intangible nature; however, they are also striving to find ways of dealing with their internal pain in order to live with their loss. WHAT IS KNOWN ALREADY: Many studies examining issues around human reproduction have tended to place childlessness in the realm of medicalised infertility and report generalised mental issues, such as depression and psychological distress, existing amongst women undergoing fertility treatments. Few studies, however, have focused on the individual with regard to the experiential significance of involuntary childlessness and living beyond the phase of trying for a baby. STUDY DESIGN, SIZE, DURATION: A phenomenologically oriented person-centred qualitative design was used. In-depth semi-structured interviews were conducted with 12 White British women, who identified themselves as involuntarily childless, recruited via three leading childless support networks in the UK. PARTICIPANTS/MATERIALS, SETTING, METHODS: In order to retain an idiographic commitment to the detailed account of a person's experience, a homogeneous and purposive sampling was used applying the following criteria: women aged between 45 and 55; in long-term heterosexual relationships with no adopted children, stepchildren or children of a partner from a previous marriage or relationship; and no longer trying to have a child. Considering the homogeneity of ethnic background and wishing to respect cultural differences, this study focused on White British women living in the UK. Of the 12, one woman was found to not meet the criteria, and therefore, the experiential data of 11 interviews were used for the study and analysed using interpretative phenomenological analysis (IPA). MAIN RESULTS AND THE ROLE OF CHANCE: Two higher-order levels of themes that illustrate intrapersonal features were identified: the intrapersonal consequences of loss and confronting internal pain. The former explicated the depth of internal pain while the latter revealed ways in which the participants deal with it in their everyday lives. The important finding here is that both themes are co-existing internal features and dynamically experienced by the participants as they live with the absence of much-hoped-for children. LIMITATIONS, REASONS FOR CAUTION: Given the homogeneous sampling and the small number of participants, which is consistent with IPA, we want to be cautious in generalising our study findings. WIDER IMPLICATIONS OF THE FINDINGS: This study offers the view that there might be potential mental health issues surrounding involuntary childlessness that are currently overlooked. Particularly because the loss of hope cannot be pathologised, and the grief is ambiguous and intangible, it might make people's grieving process more complicated. An ongoing sense of uncertainty also may persist in that involuntarily childless people may develop symptoms similar to those diagnosed with prolonged grief disorder (PGD). The overall findings elucidate the need for clinicians, counsellors and health professionals to be aware of the possible association with PGD and promote long-term support and care in helping to maintain psychological well-being for people dealing with involuntary childlessness. Furthermore, this research points to an educational application for younger people by offering information beyond an explanation of infertility and fertility treatment, helping to understand the lived experience of involuntary childlessness. STUDY FUNDING/COMPETING INTEREST(S): No funding was obtained for this study. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER: Not applicable.


Assuntos
Infertilidade , Ansiedade , Criança , Família , Feminino , Pesar , Humanos , Casamento , Pessoa de Meia-Idade
5.
J Genet Couns ; 29(6): 1015-1025, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32077165

RESUMO

Huntington's disease (HD) is an inherited neurodegenerative disorder characterized by motor problems, cognitive impairment, and mood disturbances. Given the emotional elements of both HD itself and the testing process for it, psychological interventions may be helpful for those families impacted by HD. A stand-alone genetic counseling narrative group has been offered by one regional genetics clinic in the north of England to support people's coping following predictive genetic testing for HD. Groups are held 4-5 times per year with patients attending a group on a single occasion. This study assessed participants' experiences of attending a group using the qualitative method interpretative phenomenological analysis (IPA). Telephone interviews were conducted with 12 people who had a mutation-positive HD predictive test result and who had taken part in a genetic counseling narrative group session between November 2017 and February 2018. Participants were asked about their experiences of the group and any impact it had had on their lives. Four themes emerged: 'The power of the group, 'Active elements of the narrative exercise', 'Subsequent impact of the session', and 'Another voice'. Participants described the positive impact of being able to meet and empathize with others in a similar situation, the group's positive impact on their mood and future outlook, and its beneficial impact on disclosure. While most participants were positive about the session, the final theme presented the voices of two participants for whom the groups were poorly timed. Given the sessions' generally positive impact, we recommend other centers consider offering people impacted by HD similar sessions.


Assuntos
Aconselhamento Genético/normas , Doença de Huntington/genética , Adaptação Psicológica , Adulto , Emoções , Inglaterra , Feminino , Testes Genéticos , Humanos , Doença de Huntington/psicologia , Masculino , Pessoa de Meia-Idade , Narração
6.
AIDS Behav ; 23(9): 2514-2521, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31520239

RESUMO

To inform the development of interventions to increase uptake and adherence to antiretroviral therapy (ART), we explored perceptions of ART in semi-structured interviews with 52 men and women from UK black African and black Caribbean communities. Verbatim transcripts were analyzed using framework analysis. Perceptions of ART could be grouped into two categories: doubts about the personal necessity for ART and concerns about potential adverse effects. Doubts about necessity stemmed from feeling well, doubts about the efficacy of ART, religious beliefs and the belief that treatment was futile because it could not cure HIV. Concerns about adverse effects included the fear that attending HIV services and taking treatment would lead to disclosure of HIV, feeling overwhelmed at the prospect of starting treatment soon after diagnosis, fears about side effects and potential long-term effects, and physical repulsion. The findings will facilitate the development of interventions to increase uptake and adherence to ART.


Assuntos
População Negra/psicologia , Medo , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/psicologia , Adulto , África Subsaariana/etnologia , População Negra/etnologia , Região do Caribe/etnologia , Estudos Transversais , Revelação , Feminino , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Masculino , Adesão à Medicação/etnologia , Pessoa de Meia-Idade , Percepção , Pesquisa Qualitativa , Religião , Estigma Social , Reino Unido/epidemiologia
7.
Qual Health Res ; 28(12): 1955-1958, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30241456

RESUMO

In this article, I present a rebuttal of Max Van Manen's critique of interpretative phenomenological analysis (IPA). Unfortunately, Van Manen's piece contains a series of misrepresentations of IPA and its history. Here, I answer these misrepresentations and present IPA as subscribing, and contributing, to a broad and holistic phenomenology concerned with both prereflective and reflective domains of lived experience. I contend that IPA has much to offer to our understanding of the experience of health and illness, where participants are spontaneously and actively engaged in making sense of the significant and unexpected things that happen to them.

8.
AIDS Behav ; 20(9): 2151-63, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-26767539

RESUMO

Antiretroviral therapy (ART) offers a powerful intervention in HIV but effectiveness can be compromised by inadequate adherence. This paper is a detailed examination of the experience of medication in a purposively selected group of people living with HIV. In-depth interviews were conducted with 10 HIV positive, West African women of black heritage living in London, UK. This group was of interest since it is the second largest group affected by HIV in the UK. Interviews were subjected to interpretative phenomenological analysis, an idiographic, experiential, qualitative approach. The paper details the women's negative experience of treatment. ART can be considered difficult and unrelenting and may be disconnected from the women's sense of health or illness. Participants' social context often exacerbated the difficulties. Some reported an improvement in their feelings about the medication over time. These findings point to some intrinsic and social motivators which could act as spurs to adherence.


Assuntos
Antirretrovirais/uso terapêutico , População Negra/psicologia , Emoções , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/etnologia , Adulto , População Negra/etnologia , Feminino , Infecções por HIV/etnologia , Infecções por HIV/psicologia , Humanos , Entrevistas como Assunto , Londres/epidemiologia , Masculino , Adesão à Medicação/psicologia , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Pesquisa Qualitativa , Estigma Social , Estereotipagem
9.
J Adv Nurs ; 72(11): 2662-2671, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27298133

RESUMO

AIMS: The aim of this study was to explore treatment and healthcare experiences of people living with ileostomies, so nurses can build on best practice while caring for these patients. BACKGROUND: Ileostomies, where the small intestine is re-directed out of a stoma in the abdominal wall so waste is collected using a bag, are used to treat conditions including inflammatory bowel disease. Existing research suggests that although life with a stoma can be challenging, ileostomy patients are largely supported by multi-disciplinary teams. However, more research is needed to understand the nuances of these relationships and experiences of treatment, with a view to improving clinical care. DESIGN: Participants took part in semi-structured interviews consisting of open-ended questions about their experiences of life with an ileostomy and their treatments and time in hospital. Points of interest were followed up. Data were collected between July-December of 2014. METHODS: The qualitative method interpretative phenomenological analysis was used to analyse interviews with 21 people living with ileostomies. FINDINGS: We present findings from two clinical themes: Issues around treatment and Relationships with multi-disciplinary teams. Surgical complications were common and several participants reported concerns about addiction to painkillers. Varying attitudes were found around reversal surgery. Many reported experiencing distressing, dehumanizing care, while some felt supported by excellent healthcare providers. CONCLUSION: People living with ileostomies have a very mixed experience of multi-disciplinary teams and treatments and much could be done to support them more fully. For example, more information about ileostomies could be given to patients and more training given to nurses around stomas.


Assuntos
Atitude Frente a Saúde , Ileostomia/enfermagem , Emoções , Humanos , Cuidados de Enfermagem , Estomas Cirúrgicos
10.
Psychol Health Med ; 21(7): 836-44, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-26584590

RESUMO

Demand for kidneys from deceased donors far outstrips supply. Despite this, there appears to be little research that focuses solely on the experience of waiting for a kidney from a deceased donor. This study uses the qualitative methodology interpretative phenomenological analysis to explore the lives of 10 people on the transplant list, with the aims of illuminating the potential psychological challenges those on the list may face during this time, and providing information to help clinicians more fully support such people in the future. Two themes connected to the experience of waiting - adjustment to the uncertainty of waiting and thinking about receiving a kidney from a living donor - are presented here. Participants describe a sense of confusion and uncertainty around life on the list, and discuss their strategies for dealing with this. Novel complexities around the ambiguous challenge of receiving an organ from a deceased donor are revealed. It is recommended that health care teams provide a forum for this patient group to work through these feelings of confusion and ambiguity.


Assuntos
Falência Renal Crônica/psicologia , Transplante de Rim/psicologia , Listas de Espera , Adulto , Atitude Frente a Saúde , Cadáver , Feminino , Humanos , Falência Renal Crônica/cirurgia , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Doadores de Tecidos , Incerteza , Adulto Jovem
11.
Clin Child Psychol Psychiatry ; 29(4): 1400-1416, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39161214

RESUMO

OBJECTIVE: Evaluate the cognitive, behavioural and affective processes involved in therapeutic change for young people with epilepsy and mental health difficulties receiving an integrated mental health intervention. METHODS: As part of a mixed methods convergent design, qualitative data were gathered in parallel to quantitative data at two timepoints in a randomised controlled trial testing the Mental Health Intervention for Children with Epilepsy in addition to usual care. Twenty-five young people and/or their families were interviewed before and after the intervention about the young person's mental and physical health, and their experience of therapy. Interview data were analysed inductively, idiographically and longitudinally using Interpretative Phenomenological Analysis combined with Framework Analysis. RESULTS: The young people's emotional and behaviour problems improved, mirroring the trial's quantitative outcomes. Their anxiety decreased and behaviour improved as they acquired tools and understanding through therapy. Problems, like aggressive behaviours and emotional outbursts, were also reduced, with young people gaining increased awareness and ability to self-regulate and parents learning to contain their child's impulsive behaviours. CONCLUSIONS: The qualitative findings complement the MICE trial's significant positive quantitative results by providing insight and context to the therapeutic change, providing vivid insight into the mechanisms of therapy for individual families.


This study involves young people with epilepsy and mental health difficulties who received an integrated mental health intervention called the Mental Health Intervention for Children with Epilepsy (MICE). The effectiveness of the MICE intervention (in addition to usual care) was assessed by comparing it to only usual care. This article reports on the changes in the behaviour, thinking, feeling of the young people after they received therapy. The research data was qualitative, using transcripts from interviews with 25 young people and/or their families. There was also some quantitative data, in the form of questionnaires. Both types of data were gathered at two different time points and compared over time. Then the results from the two types of data were considered together in a so-called mixed methods approach. During the qualitative interviews, participants were asked about the young person's mental and physical health, as well as their therapy experiences. The interview data were analysed using an in-depth approach to the analysis. This article describes improvements in emotional and behavioural problems among the young participants, which align with the positive mental health outcomes observed in the trial's quantitative data. Participant quotes before and after the intervention reveal reduced anxiety and improved behaviour as the therapy gave the young people new tools and understanding. Parents of young people with intellectual disabilities also felt more confident in managing their children's fears. Aggressive behaviours and emotional outbursts decreased, and young people developed greater self-awareness and self-control. The qualitative findings provide context and insight into the therapeutic change observed in the MICE trial. Understanding the mechanisms of therapy is crucial. In summary, this study sheds light on how therapy positively impacts young people's mental health and behaviour, with benefits for both the young people and their families.


Assuntos
Epilepsia , Humanos , Epilepsia/terapia , Epilepsia/psicologia , Adolescente , Feminino , Masculino , Criança , Intervenção Psicossocial/métodos , Pesquisa Qualitativa , Ansiedade/terapia , Ansiedade/psicologia , Comportamento Problema/psicologia
12.
Early Interv Psychiatry ; 17(8): 807-813, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36646667

RESUMO

AIM: Early intervention for people diagnosed with bipolar disorder is a priority, but little is known about how recovery from first episode psychotic mania is experienced by this group. This study aimed to explore the experience of recovery from first episode psychotic mania for people diagnosed with bipolar disorder. METHODS: Semi-structured interviews were conducted with 11 young adults during recovery from first episode psychotic mania and were analysed using Interpretative Phenomenological Analysis. RESULTS: Three themes were identified: (i) 'Possession of purpose and staying well', (ii) 'Coping with compromise' and (iii) 'Manic relapse: pressure and proving self'. On becoming well, the participants experienced a sense of purpose through engaging with activities and goals that also drove their efforts to engage in strategies to stay well. However, these strategies created feelings of compromise that not all were prepared to accept. Though having purpose and goals created a positive sense of direction, for a minority of the participants they also created additional pressure, contributing to manic relapse. CONCLUSIONS: The purpose created by engaging with aspirations and career-related activities during early intervention was found to be important for a meaningful recovery from first episode bipolar disorder. This instilled positivity and purpose, motivating efforts to maintain wellness. The feelings of compromise that some participants experienced point to the need for individually tailored interventions. Findings suggest a delicate relationship between the positivity of engaging in goals and the risk of manic relapse during recovery from first episode psychotic mania.


Assuntos
Transtorno Bipolar , Adulto Jovem , Humanos , Transtorno Bipolar/diagnóstico , Mania , Emoções , Recidiva
13.
PLoS One ; 18(7): e0288295, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37478122

RESUMO

Multiple Sclerosis (MS) is characterised by significant symptom diversity and complexity. The unpredictability of the symptoms and the emotional and cognitive facets of the disease have a significant impact on the patients' quality of life, relationships and other significant areas of living. Psychological interventions have been found to have moderate effects on quality of life, depression, stress reduction, improvement of wellbeing, anxiety, fatigue, sleep disturbances and emotion regulation. Most interventions so far are based on generic models of therapy which cannot always cover the complexity and unpredictability of MS. The present research project follows from an exploratory mixed method study on the experience of psychological interventions and the impact on the management of MS. The results of that study generated themes that led to the development of an integrative group psychological intervention named MyMS-Ally. The current study aims to explore the feasibility and acceptability of MyMS-Ally intervention and obtain preliminary data on the effects on quality of life, emotion regulation, depression and anxiety through the application of a convergent mixed methods design. People with MS will be recruited at the Bristol and Avon Multiple Sclerosis centre, North Bristol NHS Trust. They will participate in MyMS-Ally group intervention for 8 weeks. Individual semi-structured interviews drawing on Interpretative Phenomenological methodology will be conducted before and after the intervention and at three months follow up. Participants will complete quantitative measures on quality of life, emotion regulation, depression and anxiety before and after the intervention and at one and three months follow up. The aim is to explore the relevance, sustainability and adherence to the intervention and study processes (feasibility) as well as the appropriateness of the intervention based on the emotional and cognitive responses, satisfaction and perceived effectiveness (acceptability). It is aspired that this patient-centred psychological intervention will address needs and preferences of people with MS. The results of the present study will provide data for further development of the intervention and will lead to a big scale evaluation study.


Assuntos
Esclerose Múltipla , Humanos , Esclerose Múltipla/terapia , Esclerose Múltipla/psicologia , Intervenção Psicossocial , Qualidade de Vida , Estudos de Viabilidade , Ansiedade/terapia , Ansiedade/psicologia
14.
Dev Psychobiol ; 54(1): 70-6, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-21761404

RESUMO

In maternal potentiation, the rate of vocalization by a young organism during isolation is greatly enhanced if that isolation has been immediately preceded by an interaction with the mother (or other adult female in the case of rats). The enhancement in isolation-induced vocalization rate does not occur if the young animal had an interaction with other social companions like littermates or with familiar inanimate stimuli like home cage shavings. The present study demonstrates that pups whose vagus nerve is cut below the diaphragm do not potentiate vocalization after an interaction with their dam. The vocalization rates of denervated pups in a first isolation, in the presence of the dam, and during cold exposure do not differ from control pups. Their non-vocal behaviors also appear unaffected by the surgery. Similar to what has been shown in studies of fever-induced behavioral changes, an intact vagus nerve from the gut is necessary for young rat pups to show normal social mediation of their isolation-induced vocal responses.


Assuntos
Comportamento Animal/fisiologia , Privação Materna , Nervo Vago/fisiologia , Vocalização Animal/fisiologia , Animais , Feminino , Comportamento Materno/fisiologia , Ratos , Vagotomia
15.
Front Pain Res (Lausanne) ; 3: 901271, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36204722

RESUMO

Chronic pain is a common, profoundly disabling and complex condition whose effects on identity may explain the distress experienced by those affected by it. This paper concerns a study exploring how the relationship with pain and sense of self evolved following participation in a pain management program (PMP). Participants were interviewed at three timepoints: before attending a PMP, 1 month after the PMP and 6 months after the PMP. To facilitate a deep experiential description of pain and its effects, interviews were guided by participant-generated drawings of pain and Self. Interviews and drawings were analyzed longitudinally using interpretative phenomenological analysis. The evolving experience of participants was outlined through different trajectory types. Here we describe the upward and positive trajectory of three female participants who were able to regain control over their lives. From a state of psychological stress where pain was represented as an aggressive and oppressive presence, participants' drawings, their narratives and indeed their lives, changed for the best. Pain stopped being the main feature, they were able to integrate it into their lives, make important changes and find a new balance. The results demonstrate the idiosyncratic nature of chronic pain and offer a nuanced account of its links to the lifeworld of those living with it.

16.
J Genet Couns ; 20(1): 23-34, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20835758

RESUMO

It is important to study communication processes in families where members are undergoing testing for genetic conditions because the information received from such testing is crucial not just to the individual concerned but also to other members of the biological family. This topic has received little research attention, in part because of the complexities of methodology required. In this paper we present the development of a method specifically designed for the examination of the content and process of communication of genetic information in families. The method aims to maximize ecological validity as far as is possible. We describe how participants and other family members are recruited and how data were collected. We outline three main data analytic strategies: a graphic to show how genetic information changes as it flows from clinic and through the family, an intensive qualitative analysis of the meaning and impact of the genetic information to different family members, and an informative genogram which plots key family dynamics. This method will be illustrated in relation to a study of ten family-groups where one individual has been found to carry a genetic mutation predisposing them to hereditary breast and ovarian cancer.


Assuntos
Comunicação , Família , Testes Genéticos , Humanos
17.
Dev Psychobiol ; 53(7): 677-84, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21432845

RESUMO

Responsiveness of adult rodent caretakers to infant rodents is necessary for their survival and proper development. Both olfactory and auditory cues are known to influence adult behavior toward the young. In the present study, we found that adults respond differentially to a recording of potentiated vs. non-potentiated ultrasound vocalizations of a 12-day-old rat pup, either in the presence or absence of olfactory cues. The combination of olfactory and potentiated ultrasonic vocalization produced the greatest effect. Adult behavior was also affected by the adults' sex and parental experience in an interaction. Parental experience of females made them more responsive to the type of ultrasonic vocalization; males were little affected. Female experience, of course, includes the hormonal changes due to pregnancy and lactational state. The results are consistent with a communicatory function for isolation-induced ultrasonic vocalization.


Assuntos
Vocalização Animal/fisiologia , Animais , Animais Recém-Nascidos , Sinais (Psicologia) , Feminino , Audição/fisiologia , Masculino , Comportamento Materno/fisiologia , Ratos , Fatores Sexuais , Olfato/fisiologia
18.
Lancet Psychiatry ; 7(5): 420-430, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32353277

RESUMO

BACKGROUND: Multisystemic therapy is a manualised treatment programme for young people aged 11-17 years who exhibit antisocial behaviour. To our knowledge, the Systemic Therapy for At Risk Teens (START) trial is the first large-scale randomised controlled trial of multisystemic therapy in the UK. Previous findings reported to 18 months after baseline (START-I study) did not indicate superiority of multisystemic therapy compared with management as usual. Here, we report outcomes of the trial to 60 months (START-II study). METHODS: In this pragmatic, randomised, controlled, superiority trial, young people (aged 11-17 years) with moderate-to-severe antisocial behaviour were recruited from social services, youth offending teams, schools, child and adolescent mental health services, and voluntary services across England, UK. Participants were eligible if they had at least three severity criteria indicating past difficulties across several settings and one of five general inclusion criteria for antisocial behaviour. Eligible families were randomly assigned (1:1), using stochastic minimisation and stratifying for treatment centre, sex, age at enrolment, and age at onset of antisocial behaviour, to management as usual or 3-5 months of multisystemic therapy followed by management as usual. Research assistants and investigators were masked to treatment allocation; the participants could not be masked. For this extension study, the primary outcome was the proportion of participants with offences with convictions in each group at 60 months after randomisation. This study is registered with ISRCTN, ISRCTN77132214, and is closed to accrual. FINDINGS: Between Feb 4, 2010, and Sept 1, 2012, 1076 young people and families were assessed for eligibility and 684 were randomly assigned to management as usual (n=342) or multisystemic therapy (n=342). By 60 months' of follow-up, 188 (55%) of 342 people in the multisystemic therapy group had at least one offence with a criminal conviction, compared with 180 (53%) of 341 in the management-as-usual group (odds ratio 1·13, 95% CI 0·82-1·56; p=0·44). INTERPRETATION: The results of the 5-year follow-up show no evidence of longer-term superiority for multisystemic therapy compared with management as usual. FUNDING: National Institute for Health Research Health Services and Delivery Research programme.


Assuntos
Comportamento do Adolescente , Comunicação , Transtorno da Conduta/reabilitação , Crime/estatística & dados numéricos , Terapia Familiar/métodos , Delinquência Juvenil/reabilitação , Poder Familiar , Apoio Social , Adaptação Psicológica , Adolescente , Terapia de Controle da Ira , Transtorno da Personalidade Antissocial , Criança , Inglaterra , Feminino , Visita Domiciliar , Humanos , Masculino , Relações Pais-Filho , Rede Social , Resultado do Tratamento
19.
Parkinsons Dis ; 2019: 1937235, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30854185

RESUMO

Deep brain stimulation of the subthalamic nucleus (STN-DBS) is an effective treatment for Parkinson's disease (PD). In this study, we used an interpretative phenomenological analysis to explore how 10 male people with PD experienced life after STN-DBS surgery. Two themes emerged. The first, "Healed and relieved: all that glitters is not gold," highlights the benefits and the personal "costs" of surgery. The second, "The change within: new interpretations of the present and future unfold," explores how patients reinterpreted their lives as individuals and members of society in the present and as they face their future. Relief, gratitude, disappointment, and the need for social support are expressed as well as a new appraisal of values and the future. STN-DBS alters the life course of people with PD, and this study provides new insight into psychological and social issues that surgery raises for the patient and their family system. These psychosocial issues should be taken into account when preparing the patient and their family for surgery or supporting them postoperatively.

20.
J Health Psychol ; 13(1): 5-16, 2008 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18086713

RESUMO

There has been little research into the impact of Juvenile Huntington's Disease (JHD) on the family, and the issues facing this group are poorly understood. The study reported here is part of larger project that aimed to address this. Ten semi-structured interviews with the main carer were carried out, and were analysed using Interpretative Phenomenological Analysis (IPA). This article reports three themes arising from the study relating to the psychosocial impact of JHD on the family: (1) dealing with something so different; (2) lack of understanding (3) isolation. This information is useful in developing appropriate services for families affected by JHD, as well as being of relevance to other childhood conditions.


Assuntos
Cuidadores/psicologia , Família/psicologia , Doença de Huntington , Adaptação Psicológica , Adolescente , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Doença de Huntington/enfermagem , Entrevistas como Assunto , Isolamento Social , Apoio Social
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA